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Chest Pain

Emergency

Chest pain is one of the highest-stakes search intents in medicine. The key job is to separate immediately dangerous causes such as acute coronary syndrome, pulmonary embolism, aortic dissection, and pericardial disease from lower-risk mimics without losing time.

Red flags

  • Haemodynamic instability, hypotension, syncope, or new shock
  • Tearing pain radiating to the back, pulse deficit, or neurological features
  • Severe dyspnoea, hypoxia, pleuritic pain, or haemoptysis
  • ECG changes, arrhythmia, or persistent ischaemic symptoms

Common causes to keep in the differential

Acute coronary syndrome
Aortic dissection
Pulmonary embolism
Pericarditis / myocarditis
Pneumothorax
GORD / oesophageal pain / musculoskeletal chest wall pain

Linked MedVellum pathways

Acute myocardial infarction

Emergency

STEMI/NSTEMI framing, reperfusion, and complications.

Open topic

Pulmonary embolism

Emergency

Risk, diagnosis, imaging, and anticoagulation.

Open topic

Pericarditis

Urgent

Classic pleuritic pain, ECG changes, and recurrence risk.

Open topic

Aortic dissection search

Emergency

Jump into dissection content through the topic search.

Open topic

Next practical steps

  • Start with instability, ECG, troponin timing, and bedside observations.
  • Use the linked topics to compare ACS, PE, dissection, and pericarditis.
  • Escalate immediately when symptoms are ongoing or physiology is abnormal.

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Use MedVellum search when the presentation is mixed, atypical, or you need a broader differential before narrowing into a topic page.

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